Evidence of persistent glial cell dysfunction in the anterior cingulate cortex of juvenile idiopathic arthritis children: a proton MRS study

Abstract

Background: This study aims to investigate whether the neurometabolites of the anterior cingulate cortex (ACC) were distinct in patients with active and inactive juvenile idiopathic arthritis (JIA) using the proton magnetic resonance spectroscopy.

Methods: We measured the levels of total N-acetylaspartate (tNAA), choline (Cho), myo-inositol (ml), glutamate (Glu) and the complex of glutamate and glutamine (Glx) relative to total creatine (tCr) in ACC of each participant.

Results: Compared with the healthy controls, a significant decrease of total Cho/tCr and Glx/tCr ratio in ACC occurred in active and inactive JIA group. The tCho/Cr level was negatively associated with the serum level of ESR in active JIA patients. There was no difference in NAA/tCr ratio among the three groups, which may imply that no neuron and axonal losses occurred in either active or inactive JIA patients.

Conclusions: The abnormal neurometabolites in tCho/tCr and Glx/tCr in ACC may indicate that persistent dysfunction of glial cell, while neither neuron nor axonal losses occurred in active and inactive JIA patients.

Keywords: Anterior cingulate cortex; Glial cell; Juvenile idiopathic arthritis; Proton magnetic resonance spectroscopy.

Fig. 1

Voxel displacement. a Sagittal MP-RAGE T1-weighted slice and (b) axial T2WI showing the voxel position for the single voxel spectroscopy in the bilateral ACC (Voxel size = 30 x 15 x 20 mm3). Representative spectra acquired from the ACC in a healthy control (c) and a patient with active JIA (d)

Fig. 2

The mean ratio of brain metabolites of three groups (JIA-active, JIA-inactive, and healthy control). The JIA-active and inactive groups have lower levels of tCho/Cr and Glx/tCr than healthy control group

Fig. 3

The correlation analysis. The tCho/tCr level demonstrated an inversed correlation with ESR in acitive JIA patients